膀胱癌之漿細胞樣變體之臨床結果：單一機構經驗
吳英龍1、黃逸修1,2、林登龍1,2、張延驊1,2、郭俊逸1,2、鍾孝仁1,2、林子平1,2、黃奕燊1,2、黃子豪1、顧明軒1、黃志賢1,2
台北榮民總醫院泌尿部1 ； 國立陽明交通大學醫學院泌尿學科及書田泌尿科學研究中心2
Clinical Outcomes of Plasmacytoid Urothelial Carcinoma of Urinary Bladder: A Single Institution Experience
Ying-Long Wu1, Eric Yi-Hsiu Huang1,2, Alex T.L. Lin1,2, Yen-Hwa Chang1,2, Junne Yih Kuo 1,2, Hsiao-Jen Chung1,2, Tzu-Ping Lin1,2, I-shen Huang1,2, Tzu-Hao Huang1, Ming-Xuan Gu1, William J.S. Huang1,2
Department of Urology, Taipei Veterans General Hospital1,
Department of Urology, School of Medicine and Shu-Tien Urological Science Research Center, National Yang Ming Chiao Tung University2, Taipei, Taiwan
Purpose: Plasmacytoid urothelial carcinoma (PUC) of urinary bladder is a rare variant histology of bladder cancer. We presented our single institution experience in the treatment and clinical outcomes.
Materials and Methods: From May 2000 to December 2021, there are 31 patients diagnosed as PUC in our hospital. 10 patients were excluded because loss of follow-up or with inadequate medical records. The treatment patterns and clinical outcomes were retrospectively analyzed.
Results: In total, 21 patients were identified (15 males and 6 females, mean age 70.9 years; TNM stage 1, n=3; stage 2, n=4; stage 3, n=7; stage 4, n=7). The mean overall survival (OS) time was 19.4 months (range 0-74 months, male: 18.3 months, female: 22.3 months; stage 1: 11.3 months, stage 2: 17.3 months, stage 3: 30.4 months, stage 4: 11.6 months). There were 11 patients died of PUC with a mean survival time of 16.7 months (range 0-61 months). 10 patients were alive with a mean follow-up of 20.9 months (range 2-74 months).
The corresponding survival time of each stage according to different treatments were shown in table 1. In patients with stage 1 disease, the patient received radical cystectomy (RC) with adjuvant therapy had better survival time than TURBT alone (23 vs. 11.5 months). In patients with stage 2 disease, 50% of the patients accepted RC and the patient received systemic therapy only had better survival time than those who accepted radical cystectomy (52 vs. 7.5 months). In patients with stage 3 disease, 85.7% of the patients accepted RC and the mean survival time was 33.8 months. In patients with stage 4 disease, 57.1% of the patients were treated with systemic therapy only and the mean survival time was 15.8 months.
Pathologically, 15 patients had multifocal pattern, 17 patients had infiltrative pattern and 20 patients had high pathological grade.
Conclusions: PUC of urinary bladder is a rare variant histology of bladder cancer and mostly presented with advanced stage in our experiences. RC with systemic therapy could achieve fair survival outcomes especially in patients with stage 3 disease.